CHILD ACCIDENT REPORT FORM - COMO PRIMARY SCHOOL This form to be completed by duty teacher whenever an ‘accident? occurs in the playground that is considered to be ‘reasonably serious’. That is, Where an injury may need further medical attention, eg X-ray for sprains, Seg” stitches for cuts, bumps on the head, etc. If in doubt as to degtee of the severity of the injury teacher must consult with Principal or Deputy Principal. In all these ‘accident’ situations PARENTS. MUST BE CONTACTED, Please note for ALL HEAD INJURIES PARENTS ARE TO BE CONTACTED. Date OS // % Time /°*O2 veacher Mbeés errr Child GER Cause of Accident (to include name of other Persons injured/involved and witnesses) Se Or Pye AH Alar ot (tp thn pu bfivo 5 Lea, (2-02 ym - /egy Aone (2 (Cogn). Nature of Injuries /¥@ Ceca Sia eee ache Treatment/action taken (brief details) 77 XK proky. fe le path . Parents contacted (| (please tick) Child left at school [|] Child collected | Child taken home [7] Child taken to doctor [| Signed by_ KACHE® MARipro Jae Pritam ‘Signature